tv [untitled] July 7, 2011 7:30pm-8:00pm PDT
after fire, if we get ahold of the female and we make her well, never underestimate the lengths she will go to to make the rest of her family well. these women are not broken; they may be bent and bloodied, but they are not broken. a veteran is known as a dependable, hard-working person with high work ethics and so, if we've had someone affected by trauma, it kind of changes what they were before they were affected by it. so, if we bring that person whole again, an employer, a husband, a wife is going to have that whole person back. helping the veteran doesn't just help the veteran, it helps his children, who then grow up and contribute to the society; helps the veteran's parent; helps all those that come in contact with the veteran. and, wherever that veteran lives, it fundamentally helps that community at large. capt. hunter, as i was noting, there are some definite consequences of not treating the veterans and the rest of the military family that needs services.
absolutely. we're finding more and more of our population in the national guard has never deployed. and our suicide rate in the army national guard doubled from 2009 to 2010, so there were huge, drastic, tragic consequences for not getting assistance. and, i wanted to point out that the national guard has put in 54 directors of psychological health in all our states and territories. we have yellow ribbon programs. we have transition assistance advisor programs. we have employer support. tell me a little bit ... let's go back and let's talk about the yellow ribbon program. for example, what is it destined to do? the yellow ribbon program is a reserve component program we use in the national guard that brings service members together at various points through the deployment process, before they deploy and then at certain days after they deploy. and it allows them, with their family members,
to come back and start talking about reintegrating into civilian life, which is very different. anyone who has ever deployed, whether it's outside of the united states or even to a disaster here, is going to be affected by that deployment. and that will have an impact on the family. so, yellow ribbon events are meant to bring them back, tell them about what benefits they have, what's out there for them, and to really get eyes on individuals so they can follow up individually with that person about the program or the challenge that they might be dealing with. and some of the other programs you mentioned? yes, there's an employer support for the guard and reserve. one of the things that the employer support, we call it esgr, what they're doing now ... what does that stand for? esgr? yes, employer support for the guard and reserve. what they're doing is they're serving 80,000 employers. so we were talking about homelessness. what we're seeing is sometimes folks get deployed and they come back
and they experience something called "underdeployment." they were doing a rather menial job, then they took on a huge responsibility when they were in the service and deployed. then they come back and that job isn't as meaningful to them anymore. so we have programs in place to help people to make sure that they're gainfully employed at a level that works for them, that provides some job satisfaction for them. beyond the issue of employment and beyond the reintegration, i know that other agencies -and let's talk about samhsa- has a strategic initiative specifically designated for military families. that's correct, ivette, we do. and our administrator, when she came on board a year ago, said this is a population that we need to pay attention to, even though there is really nothing in law and there's no appropriation that says we should become involved in this. but we had discovered, frankly, from our grantees, from our substance abuse and mental health grantees
at the local level, that we did have individuals who were coming into community-based agencies and seeking help. so, the first thing we had to do is we had to recognize the fact that even the civilian agencies weren't asking people, "do you have a dd214, have you ever served in the military, have you ever been in combat?" do you want to explain the dd214? dd214 is the piece of paper that you get from the department of defense when you are, when you go off active duty and you retire. and so, the reality was that we needed to get the civilian providers thinking about this population and then directing them appropriately to va facilities and to tricare and to dod active-duty facilities, as appropriate. and then there are people who didn't want to go to those facilities or who needed care, and we saw them coming into our grantees through our family program, which was the issue about the family members, the one who's paying attention. so, we have grantees in our systems of care program, which deal with children with emotional disturbances, and we were hearing that they were not getting care
the way they wanted care in the community, either because they were far away from facilities. so, our strategic initiative is to pay attention to this population and to emphasize it as a priority, to build the collaborations with the department of veterans affairs, with the department of defense, with the national guard bureau, and to keep on collaborating until we get to the point where we can show that every service member who is eligible and who needs service will get it, no matter where it may be. and we want to see that happen in every community at the local level and at every state level. so, our initiative at samhsa is to get states to think about this in a broad way and then translate that into local community providers, action, education, and awareness. and, dr. karlin, the president also has an initiative. you want to talk a little bit about the presidential initiative on issues related to military families? we've been very fortunate because congress has recently enacted legislation that has
broadened va's authority to provide mental health and counseling services to family members. this has been a wonderful gift to the agency in so many ways, because now we're able to work directly with family members in a way we haven't been able to do before. so, within va now, we are disseminating and implementing a variety of family counseling and couples counseling services. we're now able to work with family members to help them on certain emotional issues that they might be struggling with because we know if we help the family members, that will then help the veteran, the individual as well. and so we're now able to provide couples counseling to couples, family counseling, and we're implementing throughout the veteran's health care system a variety of evidence-based, scientifically proven psychotherapies for couples and family members so that we can provide state-of-the-art care, not just to the individuals,
but to the dyads, to the couples and the family systems. the va was one of 16 departments whose secretaries signed off on the president's report, called strengthening military families . and those 16 secretaries pledged that they would approach this population with the highest priority over the next few years. it's a very significant move. and that means that even organizations like nasa, the department of agriculture, the department of justice, the department of education -all of those 16 cabinet level agencies have pledged to do something in the four areas of the report. and those four areas, very briefly, are increasing the psychological health of military service members and their families, that is the term that is used in the report; strengthening childcare education and military schools; strengthening opportunities for spousal employment; and making sure that all individual service members
have access to services everywhere. i mean, it's a tremendous, tremendous report. and, hector, where the rubber meets the road, when you're dealing with the problems in the local area, do you see, you know... what are some of the needs that still remain to be filled? obviously, we're hearing that there's all these new initiatives, and what do you think is the top priority in terms of the folks that you're dealing with? well, all of this is very admirable. i'm glad that there are things beyond service, beyond active duty, but everything begins during active-duty time. so, i also focus on making sure and just dialogue, even with the active-duty forces, because there are services there, too. there's family advocacy, there's the chaplain system, there's all sorts of counseling for financial, personal, those services are already in the active-duty force. we need, or i would like to see that continue,
to be advertised across every military installation and honed in because we need to try and attack or make the problem recognized earlier and do the best they can prior to just ... while they are deployed. right, or beyond. once they come back, i'm sure there are some areas in some installations, depending on the leadership; the leadership plays a big role here. for the 2 years that we have had the psychological program in the national guard, we've seen over 5,000 individual service members. the number one concern is family and marital concerns. so, for those that are local to their communities and their families, they have to make that connection, as hector mentioned. it has to be connected back with the state, but the guard bureau and the states themselves have lots of programs in place that mimic,
are very similar to active duty, as hector mentioned. we use our chaplain corps; we use our medical people, too. so, not to forget that the guard has programs similar to active duty. and when we come back, we're going to be talking a little bit more about services and about supporting military families. we'll be right back. they tell me i was there but i don't remember. i don't know where i really was. i do not know what i had for breakfast. i do not know who won the game. i don't recognize this man. if you or someone you know is struggling with a drug or alcohol problem, there is a solution. recovery. call 1-800-662-help for information and for hope. through treatment my life's a whole lot brighter now. brought to you by the u.s. department of health and human services (music)
i was in the army for 3 years. i suffer from ptsd and depression. as a marine, that's just something that i didn't feel comfortable doing. how do you go and say, "i think i'm losing my mind?" i did 7 years in the 82nd airborne division. i had deployed to afghanistan from '02 to '03 and, from that point on, i went to iraq from '03 to '04. i joined the army in 2000, active army, and i deployed to iraq. i was the first round deployment, so i left in january, right before the war started. and i was a truck driver so was one of the first ones over the berm into iraq. the community partnership of southern arizona is the regional behavioral health authority in pima county.
and one of the things that, as an organization, we're very much tuned into is kind of the changing needs in the community. i came to the va about 5 years ago and i had worked in the community for many years and had worked with cpsa a lot when i worked at some of the public agencies. so, i had already the relationships with a lot of the people there. and then, once i came over here, i think that partly that we were having sort of a surge in kind of more mental health funding coming into the va. there was just kind of more tension because of all the returning iraqi vets. we believe that a system like ours can be of tremendous benefit to organizations like tricare, the department of defense, in providing behavioral health benefits to enlisted military and their families. and, in fact, have developed the proposal and have been working very closely with tricare and samhsa to try and move that forward. the two issues that you really see are peer support and in-home care.
it's peer support because you must build the network of veterans, how they felt like they were in the service. you must have your brothers in arms, you must have your fellow service members standing beside you to overcome stigma, to get through this and to feel that camaraderie that you once felt. and you must get in the home. because pulling a veteran out of home, treating them, and then putting them back in their home is treating a very small portion of the problem. we recognize that consumers in our system often would really be able to provide support to their peers. yet, there really wasn't a mechanism to do that. we decided to start a recovery support institute to train and certify persons who had been through treatment in our system, that then could come out as certified recovery support specialists and work at our providers and provide services.
hope stands for helping ourselves pursue enrichment, and we're a recovery, wellness, and reintegration center. we currently have a volunteer program, which we have about 17 active veterans who are involved in our program. there are several areas where we focus. we focus on life skills; we focus on behavioral health prevention and promotion. we focus on health and wellness; and we focus on prevocational support, all in a peer support model. and all with the idea that these will increase overall socialization and reintegration back into what might be considered normal society. so if, you know, once a marine, you're always, exactly, right? creating that environment of trust, you know? when i was in the service, i was a squad leader and a team leader at the time. and the one thing i could always do is sit down with my group,
with my team, with my squad, take a knee and say, "okay, what are the issues going on that we need to address in order for us to, you know, carry on?" it's very similar to that, but we're dealing with emotional issues. in all reality, i think when you have someone you have a lot in common with, you just bond with them. it's more real and you're more willing to share with them because they understand where you come from, and these women, i think, when i talk to them, i know exactly where they've been. i know where, you feel like there's no hope, you're trying to grasp at what little bit you have and, for me to be able to be part of that and to help them get through that, that's just part of my recovery. it's a community of people that are all striving for recovery, to do better. and it's a very positive place. veterans really want to give back,
and they have had successful treatment experiences, and they feel that they have a lot to offer their fellow vets, and i think that's something that's so fantastic about working with veterans. well, i had an individual come up to me, matter of fact, yesterday, and said, "i'm glad you're here. you understand what i'm saying. nobody else seems to take the time to listen to me completely. they pretend, they act like they're listening, but they don't. but here, everybody is concerned about my welfare." i find this very gratifying, that you don't find that very often. i didn't know them before. but from just looking at them on the first day and watching what they do now, i can see my impact. and what i really didn't expect is, i'm probably about an inch and a half taller now, because i don't slump. i have a place, i'm making progress, i'm helping others.
and it changed my life. and every day i work, i get home, and i feel better than i did when i went there. i'm going to have to be twins soon, just to hold it all. kathryn, as we left off, you wanted to add a few more comments. i did, i thought what hector and captain hunter said was very important, and the first thing that hector mentioned was, the issue about the active-duty individual. the individual who comes into the military and has a military experience, and joan talked about the fact that the national guard has really recognized what that experience is and the national guard has really taken the leadership. i would challenge the other services to do what the national guard has done. because, in reality, those of us who have served in the military and have been on active duty, we never talked about emotional health, we never talked about psychological health. we were never skilled in resiliency training. and the fact that the military services are now paying attention to that is hugely important, but we have a very long way to go.
so i think people need to understand in both the civilian and military communities that we have to encourage... that the military should accept the fact that their emotional life is a part of their overall health. and that, in fact, it is important to talk about those issues and those emotions, and you can still wage war, but you have to understand the emotional connection, and i am actually very happy that the services are beginning to do some of that and particularly that the national guard is taking the lead on that. is that your experience as well? yes, i personally believe that some progress has been made. it has to go across the board and is very tough. we've been in a war for a long time and sometimes it feels like catch up at certain points. but the important thing is that we're recognizing, we're doing something, but it has to start immediately at that active-duty level, as soon as they return, have things in place. and while they're gone, to take care of their families, because they need to know that their loved ones are okay in the back, and so forth.
and dr. karlin, can the department of veterans affairs weigh in on these issues that have just been mentioned? well, we can and we can do it most effectively in partnership with samhsa, with the department of defense, with the community. and one key issue that we've been talking around but haven't really centered on yet, related to these discussions, is stigma. and we know that there is a significant barrier that gets in the way of individuals getting the help that they need. we now have treatments that work and work quite well, but individuals often don't get those treatments because of stigma. because of a psychological barrier that prevents individuals in many cases from getting the care that they need, due to fear of reprisal, due to fear of emotion or not being able to seek gainful employment. sometimes there's a perception, "if i go seek help, then i might not be able to get the job i need or i might not be able to advance in my military career the way i would like to."
so it is so important that it is not just within va and not just within dod or samhsa, but is as a nation, that we're talking more openly about mental health issues and supporting individuals. not overly supporting them in the extent that we're labeling individuals as having mental disorders when they don't, as well-it's important to recognize that. a lot of people come back from serving in the military that don't have mental disorders, but they might have some adjustment difficulties. they might have full-blown emotional disorders, so it's really important, no matter where they are in terms of their level of need, that individuals are identifying with them, meeting them kind of where they are, so to speak, and really engaging with them to try to figure out the best place for them to get the help that they might need. but first making that personal connection with a peer, with a family member, with one's physician, whomever that individual might be, it might be someone in the military.
just making a personal connection and being open to talking about "something's not just quite right." and there's help available, but we need to get over the issue of stigma. that's still important, in the national guard. i think our younger generation is doing a better job of sharing their stories, but clearly, we have put our directors of psychological health outside of the medical community, because we didn't want or believe that someone would seek assistance from someone who is going to determine whether they were fit for duty. and we wanted to take that component away. otherwise, we'd be forcing them underground, so to speak. and, it's important, and i think because we put our directors of psychological health in places where yellow ribbon, transition assistance, is available, they become part of a larger team in the national guard, to support both our airmen and soldiers. the wonderful thing the department of defense has done, i just want to acknowledge, is develop the battlemind program.
and i would encourage individuals to check out this wonderful resource. the battlemind program is accessible through the internet, and it's individuals who served in military, talking about their experiences, talking about their emotional difficulties and what their stories were and how they ultimately overcame the difficulties they were experiencing. and i think this issue about the confidentiality and career progression -that people are worried about in terms of seeking behavioral health services- is very real and has to be addressed directly by the leadership in the active-duty ranks. and that means leadership from the squad or platoon level or company level or ship level, all the way to the national level. and i see tremendous evidence that the upper echelon leadership is willing to say, "we want to respect confidentiality, we want to respect career progression, we want you to seek." and the chairmen of the joint chiefs of staff said, "it's a sign of a strong person if you seek help."
but that had to get through every single layer of the military, every single layer. that is absolutely correct. one thing is for you to listen to it in a room full of the top brass and then another thing is for the rank and file to be able to feel that comfort level. and how do we get to that comfort level? what can be done at different levels of the military to really begin to make entryway into this whole stigma issue? i think it is the issue that we've sort of touched on directly, and that is just discourse about mental and emotional well-being, ivette. i think that the military has not been used to that. the more we can do that in a natural, normal, developmental way, the civilian community does that sort of well, not well yet. but the military community and the military culture is learning how to do that, and i think that that is the base level awareness and understanding. who teaches children how to talk about their emotions?
i was never taught. i was a military kid, besides being a military officer. i lived in isolated bases all my life; i went to 16 different schools. who ever taught me about sort of the emotional adjustment that is necessary? now, i had a strong family, and that's what got us through it. but the reality is you have to name it, you have to be aware of it, you have to move it forward. and i'm very, very optimistic that that discourse is going on. hector, i want to go back to you because, in the substance use disorder community, in the addiction side, the folks in recovery are telling their stories and it's creating such a momentum. the folks that you counsel through your peer counseling program and coaching -is there that willingness for the members themselves and maybe using some of the, as you have noted, using some of the members themselves to carry that message? there is some of that. the willingness is, obviously, somebody needs to have the willingness to go through this. that's where coaching comes in,
which is to try and bring that willingness about the person. it's not giving direct advice or anything, but giving them a little bit of empowerment and, hey, you know, build from the inside, okay, and this is what i'll do. for example, and i'll use the navy, the last branch that i was in, they've also instituted something in that realm called navy more through a contract that they have with hazelden foundation in minnesota. and this is brand new, i just heard about this recently, where they can actually go online through a way of signing on and talk to other folks that are actually suffering from substance use and alcohol and that sort of thing, which i thought was a great tool to use, especially because, when they're deployed, they have no other access to things at home, but they can do it from the ships, if available. you know, you just touched on something that's very important that we haven't talked about, which is health information technologies. as we're looking for new programs, as we're looking for novel ways of getting the treatment or access to treatment,
we really do need to keep that in mind, because i think that's going to be increasingly available in the future and you may not have your traditional counselor that you speak to face to face. it's really going to be an interface through a computer that's going to be getting you the services, so i want folks to keep that in mind, and hopefully we can flash an 800 number where people can get information. i want to go back to samhsa, and i know that the military initiative is going to have some programs linked to it. i just want you to briefly mention them. certainly. the strategic initiative on military families is really embedded in our work and through our vehicles. and our vehicles are what are known as request for assistance, or rfas, which reflect competitions for grants and also through our contracts. and what you'll see across samhsa's portfolio, particularly in 2011 and going into 2012, we are embedding military families as a priority for those programs.
so you'll see, for example, a jail diversion program. there will be a priority population for military families and veterans. or, you'll see an access to recovery program, an atr program -they have been one of our most profound proponents of pushing a voucher program for substance abuse treatment- and so the atr program is prioritizing this population. and you'll see that across the entire samhsa portfolio. most importantly, for the first time, samhsa has actually put in a budget request for 2012, so it will be the first time we will ever have had money identified to do our policy academies for states, and that is in our 2012 budget, and we'll see what happens. but people should be looking out for all of samhsa's request for assistance grant and contract opportunities, because they will all prioritize in some way, shape, or form military service members, veterans, and their families. for those people who may be in need of care, who may not be getting services, in the dod facilities through tricare, or through the va.
and we're getting to the end of our show, and i would be remiss not to mention national recovery month , celebrated every september. we want to encourage everyone to go on the web page and to look at all the wonderful materials that we have and to encourage particularly military families to talk about their member of the family that has been in the military and that is now in recovery from substance use disorders or mental illness, www.recoverymonth.gov. thank you for being here, great show. for a copy of this program or other programs in the road to recovery series, call samhsa at 1-800-662-help. or order online at recoverymonth.gov and click multimedia. every september, national recovery month provides an opportunity for communities like yours
to raise awareness of substance use and mental health problems, to highlight the effectiveness of treatment and that people can and do recover. in order to help you plan events and activities in commemoration of this year's recovery month observance, the free recovery month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or outreach campaign that matches your goals and resources. to obtain your copy of this year's recovery month kit and gain access to other free publications and materials related to recovery issues, visit the recovery month web site at www.recoverymonth.gov or call 1-800-662-help. (music)